Aydoğan Fatih, Arıkan Akif Enes, Aytaç Erman, Velidedeoğlu Mehmet, Yılmaz Mehmet Halit, Sager Muhammet Sait, Çelik Varol, Uras Cihan
Department of General Surgery, Breast Diseases Service, İstanbul University, Cerrahpaşa Medical Faculty İstanbul, Turkey.
Department of General Surgery, İstanbul University, Cerrahpaşa Medical Faculty İstanbul, Turkey.
Ulus Cerrahi Derg. 2015 Aug 18;32(1):50-3. doi: 10.5152/UCD.2015.2832. eCollection 2016.
Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green.
IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection.
Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2-3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method.
According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible.
前哨淋巴结活检在乳腺癌中可采用蓝色染料法或放射性核素法或两者联合应用。吲哚菁绿荧光成像为一种新确定的方法。本研究评估通过吲哚菁绿荧光进行前哨淋巴结活检的适用性。
采用IC-VIEW（德国慕尼黑普ulsion医疗系统股份公司）红外可视化系统进行成像。注射2 mL吲哚菁绿以显示前哨淋巴结。注射后，追踪皮下淋巴管并通过同步成像找到前哨淋巴结。在前哨淋巴结在荧光引导下切除，并对切除的淋巴结进行组织病理学检查。前哨淋巴结转移患者行腋窝清扫术。
本研究纳入4例因乳腺癌行前哨淋巴结活检的患者。所有患者的前哨淋巴结均通过吲哚菁绿显影。切除的前哨淋巴结中位数为2个（2 - 3个）。2例淋巴结转移患者行腋窝清扫术。行腋窝清扫术患者除前哨淋巴结外的其他淋巴结未检测到转移。手术期间及术后未出现与该方法相关的并发症。
根据我们有限的经验，吲哚菁绿荧光引导下的前哨淋巴结活检具有同步显影的优势，在技术上是可行的。
